Transcript autism_forum - Worcester Public Schools

Worcester Public Schools
Assistive Technology Specialist
Catherine Salerno
Karen Hernandez
Kathleen Marple
Referral Process is made to the
ETC
 Request
to screen made by staff or parent
 Written request made to AT Staff
 AT Staff arranges for screening
 If necessary AT Staff recommends
supports
 If necessary, AT Staff provides
consultation
Who is referred ?
 Any
child may be referred for an Assistive
Technology Screening
 Why?
 Supports may be needed for
communication, curriculum access,
demonstrate knowledge
computer/environmental access etc.
Service Delivery
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Evaluate to determine barriers and supports necessary
to overcome barriers
Meet with educational team to determine appropriate
course of action
Provide appropriate supports through the WPS
Provide trainings to appropriate team members and
WPS students
Provide on-going consultation to team members
What is Assistive Technology?
 “Federal
Special Education Laws: PL 100407 Technology Related Assistance for
Individuals with Disabilities Act of 1988
and PL 101-476 Individuals with
Disabilities Education Act (IDEA) of 1991
defines Assistive and Instructional
Technology Devices as:
AT Definition:
“any item, piece of equipment, or product
system, whether acquired commercially off
the shelf, modified, or customized, that is
used to increase, maintain, or improve
functional capabilities of individuals with
disabilities.” ……
Any services that directly assists an individual with
a disability in the selection, acquisition, or use of
an assistive technology device” including but not
limited to :
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Augmentative and Alternative Communication
Environmental Controls
Adaptive Computer Access
Visual Aids
Assistive Listening
Mobility
Positioning and Seating
(from Toddler Talk at School MJ Co 1999)
What is AAC ?
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Augmentative and Alternative Communication
(AAC) is the term used to describe methods of
communication which can be used to add to the
more usual methods of speech and writing when
these methods are impaired.
 AAC includes unaided systems such as signing
and gesture, as well as aided techniques
ranging from picture charts to the most
sophisticated computer technology currently
available. AAC can be a way to help someone
understand, as well as a means of expression.
(from:isaaconline.com)
What can AAC do?
“AAC makes it possible for people who are unable to
express themselves through speech or handwriting to
communicate through the use of special techniques and
devices. Using strategies such as electronic talking devices
and computers, boards with pictures, alphabet or words on
them, sign language or gestures, people around the world
who have difficulty communicating can go to school or
work, develop relationships and be active in their
communities. There are people all over the world who have
an interest in AAC and who are working to promote a
greater awareness and understanding of AAC. …..(from
isaaonline.com)
Access Supports
Computer Access
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Switch Use
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Touch Window
Mouse Alternatives
 Track
Ball
Joy Stick
Switch Click
Alternative Keyboards
 Big
Keys
Intellikeys
Hand Writing Supports
Low Tech Mechanics of Writing/Drawing
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vertical/slanted surfaces – angles the writing surface for easier viewing or
reaching; may allow access from varying positions (e.g., sitting, standing,
kneeling
non-slip pads - keeps objects from slipping on table/wheelchair, e.g.,
between slantboard and table; on seat of wheelchair; under clipboard with
writing paper
time - allow more time to complete assignments
reduce quantity – require less output
fill-ins – allow student to fill in key words as opposed to writing entire
sentence
multiple choice – offer field of potential answers to circle as opposed to
writing
tactile materials - provides sensory and kinesthetic feedback
Mid Tech Mechanics of Writing/Drawing
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digital voice recorder - record homework assignments,
AlphaSmart – portable battery-powered word processor
with option of data transfer to desktop computer; simple,
easy-to-use word processor; 4/ lines of text on screen;
additional software available for more features
alternative mouse or keyboard - for
physical/visual/cognitive issues or young children
switch, trackball, joystick – alternative to keyboard
control of computer
High Tech Mechanics of Writing/Drawing
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"Easy Access" (Mac) or Accessibility Features (WIN) - Both Mac & PCs
have keyboard control panels that are already on the computer or on Utility
CDs, which come with the computer. They allow the user to use sequential
keystrokes when two keys need to be held down together. They also allow
for slowing or stopping the repeat function of keys, using the keyboard to
control mouse/cursor movement and other features.
 "word prediction software - anticipates the words the student wants by
offering a list of words to choose from and limiting key stroke
 multimedia software - can be used to create on-screen activities for
students,
 on-screen keyboard software – input via switch, mouse, joystick, trackball,
or Eye Gaze, etc., provides access to a keyboard image on screen and
letters are selected one at a time through direct selection or a process of
scanning/highlighting the keys for selection,
Writing: Comprehending, Composing, and Organizing
tactile materials - provides sensory and
kinesthetic feedback
Low Tech Comprehending, Composing, and Organizing
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posted information - post written directions for hardware and
software use; post homework on the board; post visual reminder of
topic; clearly define and post the goal and purpose of the activity;
record auditory information in a visual form to remind students and
decrease repetition
visual schedule – order of student turn-taking, daily schedule, order
of tasks
check lists - “Did I...?” or “To do...” lists which students check as they
go
object location markers – associate objects with specific activity
choices (i.e. paintbrush for easel, disk for computer); students select
activities by their object and when the objects are all selected that
area is no longer an available option; teacher shows the object
when referring to the activity to enhance understanding
Mid- tech/ Comprehending, Composing, and Organizing
personal recorder – small, hand held,
recorder to record homework assignments,
things to remember etc.
hand-held talking dictionary/speller – e.g.,
Franklin Homework Wiz & Speaking
Homework Wiz, dictionary/thesaurus; spell
check; create personal word list; words
appear on small screen; target words,
definitions, and synonyms can be
pronounced aloud in speaking version;
offers practice in cursive and print
handwriting; arithmetic tutor & calculator
High Tech Comprehending, Composing, and Organizing
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Power Point slide show (Microsoft Office) - create slide show
presentation of information; one slide per word for word
identification, review of definitions etc.; set the timing for moving
from one slide to another at a pace appropriate for the student and
increase the time as s/he improves
Web- based graphic organizers
Graphic organizing software offering a variety of formats for visually
representing, organizing, recording and relating ideas and concepts
Story Grammar Marker (Discourse Skills Productions, Inc.) – to
preview/review story narrative and support reading of text; this
interactive, tactile tool made of yarn, bead, and objects is used to
represent narrative structure; students each use smaller versions of
the Markers to work along with the teacher; aids in
organization/recall; also a terrific tool for problem-solving & solving
disputes; different versions for older versus younger students
Visual Supports for Written and
Spoken Language
Boardmaker
SymWriter
Visual Supports for
Communication
Visual Supports for Reading &
Comprehension
News 2 You
SymWriter
Google images
Communication – an essential ability in all stages
of life, necessary for addressing concerns, meeting
goals, and otherwise pursuing success and
happiness. Unfortunately, many individuals on the
autism spectrum struggle to communicate with
others.
WPS Approach to AAC
Our team approach to working with AAC is based on a “multimodal” approach to
communication—encouraging and enhancing to use a “communication system including
any and ALL signs of communicative intent and actual communicative acts. There are
MANY possible “tools in the AAC toolbox,” and the specific tool that may be most
effective in one situation, may not work at all in another. Strategies also need to be
changed, adjusted, nuanced--we have found that FLEXIBILITY and keeping an open
mind are absolutely crucial! In addition, utilizing strategies generated from solid research
and evidence-based practice (rather than anecdotal guesswork) is paramount.
The AT staff works with teachers and support staff to determine appropriate supports,
provide said supports and provide on-going training and support to help meet the
students changing needs.
Paul Visvader MA CCC-SLP © 2013 Assistive Technology Team, Boulder Valley School District,
Boulder, CO
Communication and Language
Communication and language skills allow a person to…
 Initiate, maintain, and terminate conversations
 Establish/maintain interpersonal relationships
 Share ideas
 Express feelings
 Give information
 Ask questions
 Describe events
 Solve problems
 Direct others
 Entertain
 Show imagination
 Refuse
 Learn
 Function with greater independence
 What
is the hierarchy for teaching words to
an AAC user?
 The hierarchy for teaching communication
with an AAC user is objects, photographs,
symbols, and then words.
Tangible Symbol Systems
The system uses concrete or “tangible” symbols-- objects or pictures
that stand for (or represent) something about which a student needs to
communicate. Tangible symbols may be whole objects, parts of objects,
associated objects, textures or
shapes, line drawings, or photographs. They are “permanent” (they
exist in a permanent display and don't have to be recalled from
memory), and may be manipulated by both the user and the
communication partner. Most importantly, the relationship between a
symbol and its referent is obvious to the individual user, since it is
based on the user's own experience.
Paul Visvader MA CCC-SLP © 2013 Assistive Technology Team, Boulder Valley School District,
Boulder, CO
Picture communication
Picture communication strategies typically begin with teaching the student to
associate a picture (photo, or line drawing) with a specific preferred activity or
object.
Many different methods have been developed to address all the issues
discussed above. Because each individual on the spectrum has unique abilities
and challenges, a variety of instructional techniques and therapy options are
available. The Picture Exchange Communication System™ allows nonverbal
individuals to “talk” with images; virtually simulated environments help reduce
stress, facilitating communication; and speech therapy in natural
environments brings the therapist to the client in order to remove the confines
of the office and provide real-world practice
Low Tech Tools & Strategies for Communication
expressive communication supports tools that are primarily intended to facilitate
the student’s output or expression of wants/needs, information, and social
messages; can help students communicate if they have unclear speech, limited
speech, word retrieval problems
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choice board – provides a display of the options that are available
for the student to select
topic boards – vocabulary display of messages that are related to a
specific topic
large vocabulary communication book – a book of picture
vocabulary organized into different categories (i.e. people, places,
actions, food, animals etc.); contains both personal vocabulary and
academically related terms;
letter board – portable board with printed alphabet
Mid Tech Tools & Strategies for Communication
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digitized voice-output communication aids (VOCA’s) communication devices
which use recorded speech paired with symbols to allow students to
express themselves verbally; available in a great variety of styles,
capabilities, and cost to match with student need • single message/target
voice output communication aids - capable of one recorded message and/or
has one target to select; good for students who have difficulty making an
accurate selection from a field or who has physical access issues
High Tech Tools & Strategies for Communication
 dynamic
display voice-output
communication aids – computer based
system that changes displays by selecting
targets via touch screen, mouse or
alternative access techniques
Text-based communication
We want to take advantage of
the children’s strengths to teach
them more challenging
communication and language
skills. Use of skills that the child
already has and enjoys
practicing–i.e., decoding and/or
encoding words– may facilitate
learning of new skills.
Communication Functions
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Request reinstatement of a preferred
activity/item
Refuse a non-preferred activity/item
Choose between two items (both preferred)
Choose between two items (one preferred and
one non-preferred) and more than two items
Comment on the item and/or activity
Level 1—
Emerging Communicators These are pre-symbolic
communicators who may display reflexive/reactive behavior
(laughing, crying) which is interpreted by the observer as
communicative, and this level extends on through individuals
who exhibit intentional goal-directed behavior (not
necessarily directed towards another person), and finally on
through those who exhibit intentional communicative behavior
(goal directed behavior directed towards another individual)
using gesture or natural non-symbolic means.
Paul Visvader MA CCC-SLP © 2013 Assistive Technology Team, Boulder Valley School District,
Boulder, CO
Level 2—
Beginning Symbolic Communicators might be using
some symbols: manual sign or sign
approximations, vocalizations, stylized gestures
(including pointing), and verbalizations or verbal
approximations (one through approximately 503). They
use the symbols one at a time and have not started
combining them together much, if at all. They might use
(or have tried) picture or object-based communications
strategies, or a single or double-message speech
generating device to indicate a simple greeting, the
desire for reinstatement of a preferred activity or a choice
between two activities
Paul Visvader MA CCC-SLP © 2013 Assistive Technology Team, Boulder Valley School District,
Boulder, CO
Level 3—
Intermediate Symbolic Communicators may be
using a number of (about 25 or more) symbols:
manual signs or sign approximations,
vocalizations, verbalizations (or verbal
approximations) one at a time—they may be
combining the symbols (which would imply
having close to 50 symbols in their repertoire) at
least in a rudimentary syntax or word order, e.g.,
I want.... I like... I don’t like... I go... etc.
,
Paul Visvader MA CCC-SLP © 2013 Assistive Technology Team, Boulder Valley School District
Boulder, CO
When considering a student as a potential candidate for
AAC, it is important to be aware of all of the possibilities
that exist as far as appropriate technology is concerned—
thoroughly understanding, and knowing how to use, all of
the “tools in the AAC toolbox.” There are several
different AAC classification systems in use at the present
time.
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Paul Visvader MA CCC-SLP © 2013 Assistive Technology Team, Boulder Valley School District
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Boulder, CO
In order to communicate intentionally, two factors are
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absolutely crucial
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1. that the student has a clear awareness of the
relationship between his/her behavior and the behavior
of another person (social contingency awareness:
“cause and effect” between people)
2. s/he has something specific to communicate about.
The magic ingredient here is “communicative intent”—if
the student has nothing to express, s/he will not
communicate!
Paul Visvader MA CCC-SLP © 2013
Assistive Technology Team, Boulder Valley School District, Boulder, CO
The Continuum
No Tech: These are “unaided” systems an
individual uses with no additional tools or
technology such as motor behaviors,
gestures, vocalizations, verbalizations (or
verbal approximations), proxemics
(approach, avoidance), eye gaze, and facial
expressions.
Paul Visvader MA CCC-SLP © 2013
Assistive Technology Team, Boulder Valley School District,
Boulder, CO
The Continuum
Low Tech –“No Batteries Required". These
tools are often paper based, and can be as
simple as a pad of paper and a pencil.
These are “aided” communication strategies
(i.e., requires some type of external assistance
for the symbols) which do not run from a power
source--such as picture or object
communication, PECS (Picture Exchange
Communication System), partner assisted
auditory scanning, etc.
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Paul Visvader MA CCC-SLP © 2013 Assistive Technology Team, Boulder Valley School District,
Boulder, CO
The Continuum
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Mid Tech There are two basic types of mid-tech tools.
One type of tool uses pre-recorded words or phrases,
and a button for each. The other type has a keyboard,
display, and speaker. Users type words that show up on
the display and are spoken aloud by a computer voice.
Voice output communication systems which are typically
battery operated and have a static (non-changing)
display such as the Big Mac, Rocker Plate Talker, Step
by Step, Cheaptalk, Tech Talk, Go Talk, Supertalker, or
7-Level Communication Builder.
Paul Visvader MA CCC-SLP © 2013
Assistive Technology Team, Boulder Valley School District,
Boulder, CO
The Continuum
High-tech AAC aids permit the storage and retrieval of electronic
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messages, with most allowing the user to communicate using speech
output. Such devices are known as speech generating devices (SGD) or
voice output communication aids (VOCA).A device's speech output may be
digitized and/or synthesized: digitized systems play recorded words or
phrases and are generally more intelligible while synthesized speech uses
text-to-speech software that can be harder to understand but that permits
the user to spell words and speak novel messages
Systems typically requiring an electronic power source and having a
dynamic
(changing—i.e., computerized LCD screen) display / devices • dynamic
display voice-output communication aids – computer based system that
changes displays by selecting targets via touch screen, mouse or
alternative access techniques
Paul Visvader MA CCC-SLP © 2013
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Assistive Technology Team, Boulder Valley School District,
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Boulder, CO
Factors
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are many factors that need to be
examined when assistive technology
devices and services are being considered
for a student, including educational goals,
personal preferences, social needs,
environmental realities, and practical
concerns and appropriate technology.
USING iPADS AS AAC DEVICES
Physical access can be a significant problem for some students—is s/he able to isolate
finger motions? Is s/he able to swipe or pinch? Can s/he see what is on the screen? The situation is
improving considerably with newly marketed switch interfaces and apps designed for scanning, but at
this point, it is still a significant consideration. Another question would be whether the student
understands what a picture represents or whether s/he can comprehend synthesized speech (a
computer voice). In addition,
iPad apps are nowhere near as complex and “robust” as fully-functional AAC software, so that a
student might be poorly served by a relatively simple iPad app when s/he might really need the power
and capability of a dedicated device
A final disadvantage might actually be one of the already-listed advantages: multi-functionality and
versatility. Traditional speech-generating devices have always had the communication software as
their main function and purpose …. ? An informal email poll we did of about a dozen or so international
AAC experts produced answers across the spectrum: a few suggested that the iPad, if used as an
AAC device, should be a DEDICATED device—close off all other apps as distractions
USING FACILITATED COMMUNICATION AS AAC
Facilitated communication (FC) is a technique in which a “facilitator” (a therapist, teacher, or
caregiver) gives a student consistent direct or indirect physical (and other) supports in an attempt to
promote communication: pointing to pictures or objects, pointing to printed letters or words, or typing
on a computer keyboard. According to personal anecdotal accounts and descriptions, this type of
technique may reveal previously undetected literacy and communication skills in students with autism
and other severe disabilities.
Although publicized FC success stories are both dramatic and impressive, it should be noted that
this strategy is considered “controversial” by both the American Psychological Association (APA) and
the American Speech-Language-Hearing Association (ASHA) in their 1994 and 1995 Position
Statements, respectively. In their view, in many cases it can be unclear who is really doing the
communicating and how much help the communicator is really obtaining from the facilitator
Paul Visvader MA CCC-SLP © 2013
Assistive Technology Team, Boulder Valley School District, Boulder, CO
Supports for Classroom
Management
software that supports diverse learners
phonetic/phonemic software
Student Self-Management
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verbal reminders – periodically restate the topic, focus or goal of
activity
timer – visually designate how much time an activity will take, how
much time to wait, or how much time is left in an activity; creates an
objective means of “when” – it’s non-negotiable
posters – post class rules, jobs, computer use guidelines, schedule,
etc.; use words and/or pictures to enhance understanding and quick
recognition
social stories - can alleviate anxiety about activities/tasks
(write/draw or create on computer a storybook describing the steps
of any activity, academic or nonacademic, to allow the student to
preview and be prepared for what is to come;
Reading Supports
No Tech Reading and Decoding
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strategic reading - teach students to look for particular information, e.g.,
review title/chapter headings, locate main ideas, etc. •
reduction – reduce the amount of reading required •
time - adjust allotted time for assignment •
physical/verbal - enhance meaning of reading with gestures, exaggerated
facial expressions and intonation during group reading •
choral reading – students read together • peer tutor - or adult, to support or
read to student •
finger tap for syllable counting – kinesthetic and auditory reinforcement • •
reading preview – focus on vocabulary development, story line, background
information, etc.
high interest/low reading level - locate books that are easy to read but
interesting to facilitate fluency in reading and motivation
Low Tech Reading and Decoding
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word walls - to reinforce frequently used words and topic/story vocabulary;
create on blackboard, whiteboard, or cards posted on walls; words may be
grouped together by category and color-coded
 word rings - another way to reinforce topic/story vocabulary by putting text,
drawn/cut-out/scanned pictures/drawings, story characters, Picture
Communication symbols, etc. on oaktag cards; then create rings with the
cards using binder rings, shower curtain rings, pipe cleaners or yarn
 modify worksheets – simplify format; reduce amount of text; reword in
simplified language
 graphic organizers – to preview/review story narrative, vocabulary,
characterization, etc.; e.g., concept maps, Venn Diagrams, story boards,
sequence grids, & webs (place topic in center circle, brainstormed related
ideas branch out from the topic and can later be grouped into clusters;
pictures/symbols can also be used as templates, e.g., spider, tree, flower,
etc.)
Mid Tech Reading and Decoding
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tape record text – for students to hear/review story content or to
read along with text
books on tape – to preview content/sequence of story/text (library,
audiotape purchase or rental stores, Learning Ally , BookShare
hand-held talking dictionary/speller – e.g., Franklin Homework Wiz &
Speaking Homework Wiz, dictionary/thesaurus; spell check; create
personal word list; words appear on small screen; target words,
definitions, & synonyms can be pronounced aloud if speaking
version; offers practice in cursive and print handwriting; arithmetic
tutor & calculator
High Tech Reading and Decoding
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PowerPoint slide show - create slides of words for word
identification; set the timing at a pace appropriate for the student
and increase the time as s/he improves the rate
multimedia software - adapt/modify books by, e.g., using story
graphics alone on slides to “tell” the story, putting graphics and text
together on slides, rewriting text at lower grade level, adding
symbols/rebuses to replace text or to enhance text, WEB BASED
text
text-to-speech - for reading text on computer, a.k.a. e-text or
electronic text); text reading software will read any text file aloud;
freeware/shareware programs are available
software that supports diverse learners phonetic/phonemic software
Listen ……….
E-Text
 Free

http://www.gutenberg.org/catalog/
http://etc.usf.edu/lit2go/

For a fee

• http://www.amazon.com/
• http://www.barnesandnoble.com/
Bookshare dramatically increases the accessibility of books. People with disabilities deserve the
same ease of access to books and periodicals that people without disabilities enjoy.
Intranet
Intranet
Communication boards; ready made and ready to
download
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http://www.givinggreetings.com/freestuff.html
http://teachinglearnerswithmultipleneeds.blogspot.
com/2008/02/free-boardmaker-boards-andactivities.html
http://www.speakingofspeech.com/AugCom_Mater
ials.html
http://meesterc.wordpress.com/boardmakervisuals-pictures/
http://spedat.worcesterschools.org/modules/locker/files/group
_files.phtml?parent=8616813&gid=1541156&sessi
onid=81480050bc8fb88d9cb528224e8528aa
Communication boards; ready made and ready to
download
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http://www.givinggreetings.com/freestuff.html
http://teachinglearnerswithmultipleneeds.blogspot.
com/2008/02/free-boardmaker-boards-andactivities.html
http://www.speakingofspeech.com/AugCom_Mater
ials.html
http://meesterc.wordpress.com/boardmakervisuals-pictures/
http://spedat.worcesterschools.org/modules/locker/files/group
_files.phtml?parent=8616813&gid=1541156&sessi
onid=81480050bc8fb88d9cb528224e8528aa
Contact
Worcester Arts Magnet
315 Saint Nicholas Ave
Worcester, MA 01606
508 799 3575
Or call : Special Education
@ 508 799 3056